Department of Health and Social Care

Lecanemab: Licensing

Baroness Ritchie of Downpatrick: To ask His Majesty's Government whether they intend to license the drug Lecanemab for the treatment of dementia and Alzheimer’s disease; and if so, when.

Lord Markham: The Medicines and Healthcare products Regulatory Agency will review any marketing authorisation application received, and will consider the drug with regard to quality, safety and efficacy. We do not comment on application status or applications in progress, until a full and timely decision is made with consideration of the recommendation of Commission on Human Medicines as needed. We continue to advise that patients consult with their respective healthcare professionals regarding treatment and management options for dementia and Alzheimer’s disease.

Surgery: Standards

Baroness Burt of Solihull: To ask His Majesty's Government what assessment they have made of the recent proposals of the Centre for Perioperative Care to address inefficiencies in the surgical pathway.

Lord Markham: The Government welcomes the recent manifesto of the Centre for Perioperative Care and will consider its recommendations. The Government is already working with NHS England to improve perioperative care. In May 2023, NHS England published guidance in an online-only format setting out five core perioperative care requirements relating to the care of adult patients awaiting planned inpatient surgery. These measures address the key objective of identifying health needs as early as possible in perioperative pathways, and then using time on the waiting list to optimise health, which is the Centre for Perioperative Care’s ambition for ‘preparation lists’. The NHS England National Elective Recovery and Outpatients programme is working with NHS England regional teams to help oversee and support compliance and will continue to do so throughout 2024/25.

Surgery: Standards

Baroness Burt of Solihull: To ask His Majesty's Government what steps they are taking to introduce better perioperative practices into the NHS to reduce the number of surgical cancellations, complications, and extended stays in hospital.

Lord Markham: In May 2023, NHS England published guidance in an online-only format setting out five core perioperative care requirements relating to the care of adult patients awaiting planned inpatient surgery. Implementation of these core requirements will reduce post-surgery complications and length of stay and reduce the likelihood of short notice postponement or cancellations occurring for avoidable clinical reasons. The NHS England National Elective Recovery and Outpatients programme is working with NHS England regional teams to help oversee and support compliance and will continue to do so throughout 2024/25. Beyond these requirements, we are encouraging the adoption of practices such as enhanced recovery initiatives, which minimise length of stay and reduce complications, using the Commissioning for Quality and Innovation framework as a financial incentive, and maximising day surgeries where clinically appropriate to minimise risk of cancellation from bed pressures.

NHS: Staff

Baroness Gale: To ask His Majesty's Government what is their assessment of the impact of the NHS long-term workforce planupon the number of specialists such as Parkinson’s nurses in the NHS.

Lord Markham: In June 2023, we published the Long Term Workforce Plan which sets out the steps the National Health Service and its partners need to take to deliver an NHS workforce that meets the changing needs of the population over the next 15 years.The Plan commits to double the number of medical places, taking the total number of places to 15,000 by 2031/32 and including a commensurate increase in specialty training places that meets the demands of the NHS in the future. It also commits to increasing adult nursing places by 92%, taking the number of total places up to nearly 38,000 by 2031/32.There are a record number of nurses working in the NHS and we have reached our target of 50,000 additional nurses, meaning we have delivered on our commitment six months early. In January 2024 there are over 363,000 nurses working across the NHS, representing over 62,000 more than in September 2019.

Drugs: Shortages

Lord Carlile of Berriew: To ask His Majesty's Government what steps they are taking to mitigate the current shortage of the psychotropic medication Olanzapine, Risperidone and Haloperidol following the sudden departure of two generic manufacturers from the UK market.

Lord Carlile of Berriew: To ask His Majesty's Government what assessment they have made of the impact of the shortage of the psychotropic medication Olanzapine, and what steps they are taking to ensure that such shortages do not affect the health and safety of patients, and wider public safety.

Lord Markham: We are aware that there have been supply constraints with olanzapine 210 milligram, 300 milligram, and 405 milligram powder and solvent for prolonged release suspension for injection. We worked with manufacturers to uplift production, and the issues were resolved in February 2024. We worked with NHS England to issue national communications containing advice on how to manage patients whilst there was a disruption to supply. We are not aware of any supply issues affecting oral presentations of olanzapine, or of any supply issues with any risperidone or haloperidol products.

Drugs: Prices

Lord Hunt of Kings Heath: To ask His Majesty's Government when they will publish a timeline for the implementation of the proposed changes to Drug Tariff Part IX; provide the definition of "quality" that will be used as part of the enhanced assessment process included in those proposed changes; and publish in full the responses received to that consultation.

Lord Hunt of Kings Heath: To ask His Majesty's Government whatplans they have to consult patients, clinicians and manufacturers on the categorisation of products available on Part IX of the Drug Tariff as proposed in the recent consultation paper; and what assessmentthey have made of the impact of the proposed changes to Drug Tariff Part IX on (1) patients with continence care needs, (2) continence care services, (3) the range of devices available to clinicians and patients, and (4) new product development and innovation in medical devices in the continence sector.

Lord Markham: The consultation response on the proposed amendments to Part IX is expected to be released in May 2024, which will outline the Government’s response. Any amendments that are taken forward will happen gradually, with review points, and engagement with stakeholders, including industry, patient representatives, clinicians, and National Health Service organisations. The Department will share a timeline of the proposed changes taken forward in due course.The Department believes that it is currently difficult to identify which devices are broadly comparable, and whether more expensive devices provide added value. The proposed amendments that were consulted on intend to increase meaningful choice, not to decrease choice for clinicians and patients. Comparison between products can increase awareness of different brands amongst prescribers, which can also support small and medium sized businesses in entering the market.The Department is aware that there are some very good devices in use, relied upon by clinicians and patients. Part IX will remain a list of devices available to be prescribed in the community via the FP10 prescription route.

Tofersen: Licensing

Baroness Finlay of Llandaff: To ask His Majesty's Government what assessmentthey have made of the negative impact on pharmaceutical research investment in the UK of the refusal by National Institute for Health and Care Excellence to approve tofersen for SOD-1 MND patients in the UK.

Baroness Finlay of Llandaff: To ask His Majesty's Government what considerationwas given to the costs of complicated grief in families of patients dying from SOD-1 MNDduringthe evaluation process that led to the decision to decline access to tofersen for NHS patients.

Lord Markham: The National Institute for Health and Care Excellence (NICE) has not yet started its evaluation of tofersen for treating amyotrophic lateral sclerosis caused by SOD1 gene mutations, and has therefore not published any guidance or recommendations on whether tofersen should be available for National Health Service patients. In developing its recommendations, the NICE will follow its published methods for health technology evaluation, which will include a thorough assessment of the available evidence. This takes into account all health-related costs and benefits, including health benefits not only to patients but, where relevant, to other people such as carers. The NICE’s aim is to publish its guidance on tofersen as close as possible to the date it receives its marketing authorisation.

Drugs: Prices

Baroness Finlay of Llandaff: To ask His Majesty's Government what progress they have made with the proposed amendments to the Part IX of the Drug Tariff, including any impact assessments on the future provision of medical technologies in the UK; how these proposals meet the ambitions of the Life Sciences Vision; and what steps they are taking to ensure that there is sufficient patient choice following the outcome of the consultation.

Baroness Finlay of Llandaff: To ask His Majesty's Government how they plan to formally engage with the wider health sector and industry partners on the next stages in the development of proposed changes to Part IX of the Drug Tariff, following the conclusion of the consultation on these proposals.

Lord Markham: The consultation response on the proposed amendments to Part IX and the final impact assessment is expected to be released in May 2024, and will outline the Government’s response.The Department believes that it is currently difficult to identify which devices are broadly comparable, and whether more expensive devices provide added value. The proposed amendments that were consulted on intend to increase meaningful choice, not to decrease choice for clinicians and patients. Comparison between products can increase awareness of different brands amongst prescribers.These proposals support the Life Sciences Vision, and are designed to increase innovation and alignment between partners in the health and care system. The enhanced assessment process will allow comparison between products based on their merits, increasing transparency and competition, and encouraging new products and small and medium sized businesses to enter the market. The proposed introduction of environmental attributes in social value scoring increases the vision to help the National Health Service meet Net Zero.The Department is aware that there are some very good devices in use, relied upon by clinicians and patients. Part IX will remain a list of devices available to be prescribed in the community via the FP10 prescription route. Any amendments that are taken forward will happen gradually, with review points and engagement with stakeholders, including industry, patient representatives, clinicians, and NHS organisations. The Department will share a timeline of proposed changes taken forward, in due course.

Health Professions: Mental Health

Lord Turnberg: To ask His Majesty's Government what assessment they have made of the impact on the mental health of medical practitioners of withdrawingNHS Practitioner Health services for new applicants.

Lord Markham: We recognise that the NHS Practitioner Health service is valued by many doctors. NHS England is reviewing the service as part of a wider review of its mental health and wellbeing offer to National Health Service staff. It was confirmed on 15 April 2024 that the service will continue to accept new patients from primary and secondary care whilst this review is undertaken over the next 12 months. NHS England will confirm future arrangements once the review has been completed.

Department for Work and Pensions

State Retirement Pensions: Women

Baroness Ritchie of Downpatrick: To ask His Majesty's Government when they will respond to the report from the Parliamentary and Health Service Ombudsman Women’s State Pension age: our findings on injustice and associated issues laid before Parliament on 21 March.

Viscount Younger of Leckie: In laying the report before Parliament at the end of March, the Ombudsman has brought matters to the attention of this House, and a further update to the House will be provided once the report's findings have been fully considered.

Department for Environment, Food and Rural Affairs

Plants: Northern Ireland

Baroness Hoey: To ask His Majesty's Government which plants, trees and seeds are not allowed to be sent to Northern Ireland from Great Britain as a result of the Windsor Framework.

Lord Douglas-Miller: The Windsor Framework provides for simplified arrangements for the movement of plants and plant products between Great Britain and Northern Ireland, meaning a phytosanitary certificate is not required and that a wider variety of plants can move. We have secured the lifting of a ban on the movement of twelve plant species - apple, Japanese / delavay privet, European crab apple, common hawthorn, Norway maple, Japanese maple, sycamore maple, field maple, English oak, sessile oak, European beech and, most recently, hazel. We are in active dialogue with the EU Commission on a number of other species which industry has proposed as priorities. We will continue to engage with industry to ensure the smooth movement of additional plant species. Further details can be found on Defra’s online Plant Health Portal.

Foreign, Commonwealth and Development Office

Israel: Gender Based Violence and Sexual Offences

Baroness Helic: To ask His Majesty's Government what assessment they have made of reports by UN experts on 19 February of “credible allegations of egregious human rights violations” against Palestinian women and girls in Gaza and the West Bank by Israel Defence Forces; and whether they have offered practical support for investigating these alleged crimes, and for caring for survivors and witnesses.

Lord Ahmad of Wimbledon: The UK condemns human rights abuses and sexual violence unequivocally and without exception. As I [Lord Ahmad] said to the UN Security Council during the 11 March debate following the release of Special Representative Pramila Patten's report, it is vital that all reports of sexual violence are fully investigated to ensure justice for all victims and survivors and perpetrators are held to account.The FCDO continues to closely monitor the situation in Israel and the Occupied Palestinian Territories and stands ready to further utilise our Preventing Sexual Violence in Conflict Initiative (PSVI) expertise and tools to ensure victims and survivors of CRSV, both Israeli and Palestinian, receive the holistic and survivor-centred support they need.Through our PSVI programmes and dedicated funding totalling £60 million since 2012, we are leading work internationally to prevent conflict-related sexual violence and strengthen justice and support for all survivors.

Bahrain: Visits Abroad

Lord Scriven: To ask His Majesty's Government whether Bahrain has paid for the flights or accommodation of any Minister visiting that country in the past four years; and if so, who the Ministers were, what were the reasons for their visits, and the cost of (1) the flights, and (2) the accommodation.

Lord Ahmad of Wimbledon: We do not hold this information on behalf of HMG; it is held by each Government department for their own ministers. In the case of FCDO Ministers, we do not hold this information centrally and it could only be obtained at disproportionate cost.The FCDO publishes details of FCDO Ministers' meetings with external organisations, gifts (given and received), hospitality and overseas travel every quarter. This information can be found at https://www.gov.uk/government/collections/fcdo-ministerial-gifts-hospitality-travel-and-meetings.

UNRWA: Textbooks

Lord Turnberg: To ask His Majesty's Government whether they have any evidence that UNRWA is inciting hatred of Jews in the textbooks it provides in its schools in Gaza.

Lord Ahmad of Wimbledon: We regularly discuss issues related to the school curriculum and textbooks with the Palestinian Authority (PA) and UNRWA. The UK-supported 2021 review of the PA curriculum found improvements in content, with previously flagged materials removed. But it also indicated that problematic content remains in Palestinian textbooks: we therefore need to see further curriculum reform from the PA, and we continue to raise this with them regularly. UNRWA and the PA are engaging seriously on this issue.Antisemitism is abhorrent and has absolutely no place in any society, and we are committed to tackling it in all its forms.